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Is Changing Institutional Culture the Key to to Ending Gender Bias?

Stanford School of Medicine Tackles Problem of Lack of Women Faculty with Bold Pilot Program

joureny of a thousand milesIn 1991, Stanford School of Medicine found itself with publicity it would rather not have–Neuroosurgeon Frances K. Conley, MD most publicly resigned her professorship over an intransigent culture of misogyny and harassment.  Detailed in her 1998 book, Walking Out on the Boys, Conley, the first tenured full professor of neurosurgery in the country, depicts an institution in serious need of change.

Fast forward the clock.  Standford continues to be known as a “high-power” (code word for b-buster) medical academic institution.  Faculty commit themselves to an academic career that often includes 65+ hour work weeks and 110% effort to their work, leaving little time for much else.  And as pointed out in the September issue of Harvard Business Review, this situation is not conducive to recruiting and retaining women faculty who can mature into female leaders.

What’s an institution to do?  Stanford’s answer:  change the culture of the institution.  Easier said than done.  But the first step–recognition that culture change is the key to ending gender bias–is the most difficult and the most important.  And to change a culture, Stanford has chosen the Deloitte and Touche model of career customization coupled with sweeping changes in their work-life flexibility policies and procedures that are heretofore seldom used, and like most, serve no one as intended.

Stanford has recognized that it is not enough to have “a stable” of policies that allow for clock stopping, give time off for family leave, grants for child care and on-site day care, to name a few of their (usually absent at many other institutions) policies.  But in high powered academic medicine, where the departmental “team” is tightly woven together, and the absence of just one person for even a short period of time  can put undue burden on colleagues (with subtle and not-so subtle resentment) and often is read as a signal that the person taking “leave” is opting out of this elite club (with overt punishment of being left behind).

Key components to their innovative (well at least in academic medicine) plans include:

  • Engage institutional leadership–hopefully this means that the leader’s successes and rewards are tied to the success of this program.
  • Increase the use of flexibility policies by making their use part of the culture–hopefully this means reward everyone, both male and female faculty, for using these policies.  Participating in the culture change is as important as publishing a scientific paper.
  • Change the system by which women academic’s work is valued by use of a “banking system” where teaching, teaching, mentoring and service (tasks often taken on by women faculty) are given as much credit as the research commitment that is traditionally almost exclusively valued for promotion to career advancement and access to leadership positions.

Serving 50 faculty (the gender make up is not stated) in what sounds like a multi-year (not to short, we hope) pilot program, Stanford has come a long way.  Let’s hope their efforts prove that cultures can change when it is in their best interests to do so.  Tapping into the other 50% of a talented physician workforce is essential for even the best of academic institutions.  After all,  “The journey of a thousand miles starts with a single step.” (Lao-Tzu, Chinese philosopher 604-531 BCE).  Let’s hope Stanford is leading the way for others to start this journey.



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